Archives Of Heart-watch-blog From Medicineworld.Org

June 15, 2006, 10:41 PM CT

Growth Factor Triggers Growth Of New Blood Vessels In The Heart

The newest concept for treating coronary artery disease is to induce hearts to grow their own new blood vessels to bypass damaged tissue or clogged arteries. Unfortunately, clinical trials of two important blood-vessel growth factors -- fibroblast growth factor 2 (FGF2) and vascular endothelial growth factor (VEGF) -- have not produced stellar results.

Now scientists at Washington University School of Medicine in St. Louis have investigated a third signaling molecule -- called Sonic hedgehog -- that could overcome problems associated with FGF2 and VEGF treatment.

In a report appearing in the June 15 issue of Genes and Development, the team showed that activating hedgehog signals in adult mouse hearts led to an increase in the density of blood vessels in the heart.

Their findings suggest that a drug therapy that turned on or increased hedgehog signals could provide substantial benefit to patients suffering from ischemic heart disease and myocardial infarctions and offer an alternative to invasive procedures like surgery or angioplasty.

About 12 percent of heart patients are not eligible for bypass surgery, which redirects blood around clogged arteries, or for other procedures routinely used to open clogged vessels. That means each year in the United States, 100,000 to 200,000 patients could benefit from having another option for improving blood flow in the heart, as per the study's authors.........

How Do You Measure A Broken Heart?

The answer to a 50-year-old question has been found by researchers at Washington University School of Medicine in St. Louis. The question: Is it possible to accurately measure the intrinsic filling function of the heart?.

Sound esoteric? Consider that about half of people with heart failure have problems correlation to how well the heart fills with blood during the relaxation phase - referred to as diastole. Furthermore, these problems often develop earlier than problems with the contraction phase of the heartbeat - called systole. And consider that a person can have normal systole and yet have abnormal diastole. That fact, coupled with the lack of a reliable way to measure intrinsic filling function, has caused abnormalities of the filling process to be incompletely recognized.

"Only in the last decade have physicians really become aware of the importance of the diastolic process and have come to recognize the syndrome of diastolic heart failure," says senior author Sándor J. Kovács, M.D., Ph.D., associate professor of medicine, of cell biology and physiology and of biomedical engineering and adjunct associate professor of physics. "When heart muscle loses its normal ability to simultaneously relax and spring back after contracting, it fails to move properly during filling. This causes blood to start backing up into the lungs with the patient developing life-threatening pulmonary edema (fluid in the lungs) and related symptoms."........

Using Device To Give CPR

Scientists looking for methods to improve survival from cardiac arrest were surprised by the results of a study comparing manual CPR compressions with those given by an FDA-approved mechanical device.

The randomized study, conducted in five North American cities including Columbus, showed that victims of sudden cardiac arrest were more likely to be discharged alive from the hospital if they received manual cardio-pulmonary resuscitation (CPR) rather than CPR administered by the mechanical device.

Results of the study are reported in the June 14 issue of the Journal of the American Medical Association.

Lynn White, clinical research manager in emergency medicine at Ohio State University Medical Center, coordinated the 34 medic crews involved in the Columbus study. "Everyone thought the device was a great idea and that its ability to provide compressions of much higher quality than those administered by humans would be lifesaving," said White. "The results are certainly not what we anticipated at the onset of the study."

The study involved 1,071 people who experienced out-of-hospital cardiac arrest in Columbus, Seattle, Pittsburgh, and Vancouver and Calgary, Canada. The study, originally planned to last 12-18 months, was halted in March 2005, nine months after it began, when it became apparent that the study device was not improving long-term outcomes.........

Drinking Coffee May Protect Liver

Drinking coffee could help protect against alcohol-related cirrhosis of the liver. That's the finding of a new study in the June 12 issue of the Archives of Internal Medicine.

Scientists at Kaiser Permanente in Oakland, Calif., followed more than 125,000 health plan members who underwent a medical exam between 1978 and 1985. At the time, none of the members had diagnosed liver disease. Participants filled out a questionnaire detailing how much alcohol, coffee and tea they drank per day. By the end of 2001, 330 participants had been diagnosed with liver disease, including 199 with alcoholic cirrhosis. The scientists found that the more coffee a person drank, the less likely they were to develop alcoholic cirrhosis of the liver.

"Consuming coffee seems to have some protective benefits against alcoholic cirrhosis, and the more coffee a person consumes the less risk they seem to have of being hospitalized or dying of alcoholic cirrhosis," said Arthur Klatsky, MD, an investigator with Kaiser Permanente's Division of Research and the lead author of the study. "We did not see a similar protective association between coffee and non-alcoholic cirrhosis".

"This is not a recommendation to drink coffee," said Klatsky. "Nor is it a recommendation that the way to deal with heavy alcohol consumption is to drink more coffee. The value of this study is that it may offer us some clues as to the biochemical processes taking place inside liver cells that could help in finding new ways to protect the liver against injury."........

Possible Effects Of Actos Beyond Glycemic Control

Scientists today at the American Diabetes Association (ADA) 66th Annual Scientific Sessions presented data showing the relationship between baseline characteristics and cardiac risk factors in patients enrolled in a new clinical trial called CHICAGO (Carotid intima-media tHICkness in Atherosclerosis using pioGlitazOne). This is the largest and longest study to examine the effects of ACTOS on measures of the atherosclerotic disease process in patients with type 2 diabetes, most of whom had no clinical evidence of heart disease.

"While earlier and smaller studies found that ACTOS reduced carotid intima-media thickness, given the size and duration of the CHICAGO trial, we hope to gather further information about the effect of ACTOS on blood vessel health and atherosclerosis," said Theodore Mazzone, M.D., F.A.C.P., professor of medicine and director of the Section of Endocrinology, Diabetes and Metabolism at the University of Illinois at Chicago. "We look forward to further study findings, as we hope they can provide important information and insight about management of cardiovascular disease in people with type 2 diabetes."

The CHICAGO trial is an 18-month, multicenter, randomized study that has enrolled 439 patients with type 2 diabetes, all from the Chicago area, thus the name of the study. The primary goal was to compare the effects of ACTOS versus glimepiride, a sulfonylurea, on carotid intima-media thickness (CIMT), defined as the thickness of the inner lining of a patient's neck arteries. It is also assessing the occurrence of cardiovascular events (i.e., death, heart attack and stroke) and cardiovascular disease risk factors among patients with type 2 diabetes.........

Assessing Risk Of Heart Disease In Ethnic Groups

A new web-based calculator will better assess the risk of heart disease in British black and minority ethnic groups. These groups are often wrongly assessed.

ETHRISK is for everyday use in the doctor's surgery and other primary care settings. It has been developed by scientists at the University of Bristol to improve prediction of the heart disease risks of seven British black and minority ethnic groups.

Ethnic groups within Britain have a different risk of coronary heart disease (CHD) and cardiovascular disease (CVD), when compared with the general population in Britain. However, their risks are not being correctly assessed, due to the outdated method of calculation.

Dr Peter Brindle, lead author on the paper published online today in the BMJ journal Heart, said: "The ETHRISK calculator adjusts for ethnic groups and is based on a re-calibration of the Framingham risk equations. It provides a much more realistic assessment of the risk of having heart disease and stroke within a 10-year period, faced by an individual from one of these groups.

"Once the blood pressure and cholesterol measurements have been taken, the nurse or doctor can go online and plug in the numbers to get a more accurate risk score for that individual. ".

The recommended way of preventing heart disease involves using the Framingham risk score to identify high-risk patients. Patients above an agreed threshold are prescribed preventive therapys. However, the relevance of the Framingham score to the British population is uncertain, especially when applied to ethnic groups, because the US data on which Framingham is based, are over 20 years old.........

Green Tea And The 'Asian Paradox'

There is a lower incidence of cardiovascular disease and cancer in Asia where people smoke heavily, which may be accounted for by high consumption of tea, especially green tea, as per a review article published by a Yale School of Medicine researcher.

"We do still not have a full explanation for the 'Asian paradox,' which refers to the very low incidence of both heart disease and cancer in Asia, even though consumption of cigarettes is greater than in most other countries," said Bauer Sumpio, M.D., professor and Chief of Vascular Surgery in the Department of Surgery. "But we now have some theories."

Sumpio, the lead author of the review in the Journal of the American College of Surgeons, said he and colleagues reviewed more than 100 experimental and clinical studies about green tea in writing the article.

He said one theory is that the average 1.2 liters of green tea consumed daily by a number of people in Asia offers the anti-oxidant protective effects of the polyphenolic EGCG. EGCG may prevent LDL oxidation, which has been shown to play a key role in the pathophysiology of arteriosclerosis. EGCG also reduces the amount of platelet aggregation, regulates lipids, and promotes proliferation and migration of smooth muscle cells, which are all factors in reducing cardiovascular disease, he said.........

Type of Stress, Not Duration, Key to Heart Enlargement

When judging whether or not an enlarged heart is healthy or potentially at risk for heart disease, the nature of the physiological stress that produced the enlargement is more important than the duration of the stress, as per a new study led by Duke University Medical Center investigators.

This distinction has significant clinical implications, the scientists said. While enlargement of the heart can be a natural and beneficial response to exercise training, it can also be an early warning sign for such harmful conditions as heart failure.

These findings, based on a series of experiments in mice, could help settle a long-running controversy among cardiologists concerning heart enlargement, or cardiac hypertrophy, as per Duke cardiologist Howard Rockman, M.D., who led the team of Duke and University of North Carolina-Chapel Hill researchers.

The scientists published their findings on June, 1, 2006, in the Journal of Clinical Investigation. The study was supported by the National Institutes of Health.

"If you look at the hearts of athletes, they are larger than normal," Rockman said. "Conversely, patients with hypertension also tend have larger-than-normal hearts. So why are some cardiac overloads, such as exercise, good for the heart, while others, such as high blood pressure, not?".........

Overweight And Obesity Enlarges Teenagers' Hearts

The effects of excess weight on heart health can be seen even in adolescents, with abnormal enlargement and impaired pumping function evident in subjects by age 20, as per a new study in the June 6, 2006, issue of the Journal of the American College of Cardiology.

"Heart damage starts very early in the natural history of obesity. We need to work on our young people, to prevent catastrophic effects later on," said Giovanni de Simone, M.D., F.A.C.C. from the New York Presbyterian Hospital-Weill Medical College of Cornell University in New York, New York and the Federico II University Hospital School of Medicine in Naples, Italy.

The Strong Heart study (SHS) is a longitudinal study of cardiovascular risk factors and cardiovascular disease that enrolled 4,549 people in American Indian communities in Arizona, Oklahoma, and North and South Dakota. This analysis included data from examinations of 460 participants age 14 to 20 years (245 girls and 215 boys). The scientists used ultrasound and other methods to measure the size, shape and pumping function of the teenagers' hearts.

The left ventricles of the hearts of both overweight and obese teenagers were larger and heavier than those of normal weight participants; but the obese teenagers also showed signs of impaired heart function. The changes were not entirely explained by changes by high blood pressure.........

Eat Pistachios To Protect Heart

Scientists from Turkey say that eating pistachios can protect you from heart disease. Turkey is the world's fourth largest pistachios producer. Adding pistachio nuts to your daily diet could be an easy way to improve cholesterol levels, say scientists from Turkey, the world's fourth biggest pistachio nut producer.

The US is currently the number two producer of pistachios in the world, with annual production of about 136,000 metric tons (302m lbs). Exports of the nuts are worth almost $100m every year with Europe getting the lion's share of the exported nuts (71 percent).

The new study, reported in the journal Nutrition, Metabolism and Cardiovascular Diseases (Vol. 16, pp. 202-209), randomly assigned 44 healthy volunteers with an average age of 33 and a BMI of 24.5 kg per square meter to a regular diet (control) or the test diet with 20 percent of the daily calorific intake from pistachio nuts.

After three weeks of the diet, the researchers, from the Medical Faculty of the Harran University in Turkey, found that plasma levels of total cholesterol decreased by 12 percent for the pistachio group, compared to baseline, and HDL cholesterol levels increased by 26 percent.........

Heart diseaseAbout 13 million Americans (about 7 percent of the total population) suffer from coronary artery disease. Coronary artery disease is the leading cause of death in American men and women amounting a staggering 20 percent of all causes of death. About half of all deaths related to cardiovascular diseases occur from coronary artery disease. Through this heart watch blog we will have our humble contribution towards making men and women aware of the risks of heart diseases.